Dr. Esin Özlem Atmış
Brow Lift
Raising and reshaping a low or heavy brow so the upper face looks rested, without a surprised expression.
Facial surgery · Forehead, brows and temples
The brow where it belongs, not higher.
A brow lift raises and reshapes eyebrows that have descended, a change that can make the face look tired, sad or angry. It is often combined with eyelid surgery, because upper eyelid surgery alone cannot reposition the eyebrow.1
More than half of brow lifts today are done endoscopically, through small incisions in the hairline.2 This page explains the different techniques, who each suits, preparation, recovery, risks and planning a stay in Istanbul.
In short
- Treats a low or heavy brow, forehead heaviness and upper eyelid hooding that comes from the brow.1,2
- Endoscopic, hairline, temporal or direct techniques; forehead height and the hairline guide the choice.1,3
- Stitches or staples come out at about one week; most patients are back to routine within two weeks.1,2
- Some settling of the lift is expected and planned for.2
- Plan about a week in Istanbul; usually one night in hospital.
Who a brow lift can help
- brows that sit low, especially at the outer tail, making the eyes look hooded;2
- a heavy forehead or deep lines between the brows and across the root of the nose;2
- upper eyelid heaviness that disappears when you lift your brows with your fingers;
- in some cases, restricted upper field of vision caused by the heavy brow.2
A brow lift is used with caution when the brows differ in height by more than three to four millimetres, when the eyelids do not close fully, or when there is dry eye or earlier eyelid surgery.2
Brow lift or eyelid surgery? Removing upper eyelid skin does not lift the brow. If both have changed, both may be planned, often in the same operation; see eyelid surgery.1
Techniques: which incision, and why
| Technique | Where the incision is | Often suits |
|---|---|---|
| Endoscopic | Several short incisions in the hairline1 | Most patients; favoured when the forehead is short (under about 6 cm)2 |
| Hairline (pretrichial) | Along the front hairline1,3 | A high forehead, which it can also shorten; not suitable for a receding hairline1,3 |
| Temporal (lateral) | Short incisions in the temple hairline | Mainly a low outer brow tail |
| Direct | Just above the eyebrow1 | Selected cases, usually older patients with deep forehead lines |
| Coronal | Across the top of the scalp1 | Rarely used today1 |
The shape matters as much as the height. Over-elevating the inner brow creates a surprised look; most faces need the lift mainly at the outer half. Patients interested in a more lifted outer eye may also read about almond eye surgery.
Before surgery: blood thinners, supplements and smoking
Bring a written list of every medicine, injection and supplement you take, including doses. The table shows what usually happens; it is not an instruction to stop anything yourself. Blood thinners protect against stroke and clots, so any pause is agreed with the doctor who prescribed them.4
| Medicine | What usually happens before planned surgery |
|---|---|
| Warfarin | Usually stopped about five days before surgery; some patients need a temporary heparin injection plan.4 |
| Apixaban, rivaroxaban, edoxaban, dabigatran | Usually paused one to two days before, depending on bleeding risk; dabigatran needs longer when kidney function is reduced.4 |
| Clopidogrel, ticagrelor, prasugrel | If the cardiologist agrees, usually stopped about 5, 3 to 5, and 7 to 10 days before respectively. After a recent coronary stent, planned surgery is often postponed.4 |
| Aspirin | Often continued when it is taken to protect the heart; the decision is individual and made with your prescribing doctor.4 |
| Ibuprofen, naproxen and similar painkillers | Increase bleeding and are usually avoided before surgery; paracetamol is the usual alternative.5 |
| Vitamin E, ginkgo, garlic, ginseng and other supplements | Can increase bleeding; usually stopped at least two weeks before, sometimes three.6,7 |
| Weight-loss or diabetes injections (GLP-1 medicines such as semaglutide or tirzepatide) | Most people can continue them, but the anaesthesia team must know. Surgery may be postponed during dose increases or if you have nausea or vomiting; some patients need a liquid diet for 24 hours before.8 |
Bleeding disorders. Tell us at the first contact if you have a diagnosed bleeding disorder (for example von Willebrand disease or haemophilia), a low platelet count, liver disease, or a history of unusual bleeding after tooth extractions, operations or with periods. Blood tests and a haematology opinion come before any surgical plan. Some people are better served by not having elective cosmetic surgery at all.
Blood pressure and diabetes. Poorly controlled blood pressure or diabetes increases the risk of a collection of blood under the skin (haematoma) and of poor healing; both should be well controlled before surgery.7
Smoking and nicotine. Stop all nicotine, including vapes, patches, gum and snus, at least three to six weeks before surgery and for three to six weeks afterwards. Nicotine narrows small blood vessels and raises the risk of wound problems and skin loss; if you relapse, tell us, because postponing is safer.9
The operation
An endoscopic brow lift is done under general anaesthesia. Through short hairline incisions the forehead tissues are released with the help of a camera, lifted and fixed in the new position; small fixation devices may be used and can be felt under the scalp for five months or longer.2 Eyelid surgery or a midface lift can be added in the same session.
Recovery and risks
| Time | What is typical |
|---|---|
| First 48 hours | Cold compresses, head raised; tension-headache-like discomfort for a day or two1,2 |
| Day 1 | Head dressing removed; showering usually allowed2 |
| About 1 week | Stitches or staples removed; sleep with the head raised during this week1,2 |
| 2 weeks | Most people are back to their normal routine; no vigorous activity until then1,2 |
| 1 month | Hair colouring allowed2 |
| 3 and 12 months | Result reviewed; about 5 mm of settling is anticipated in planning2 |
Risks include numbness or itching of the forehead and scalp, a small area of hair loss at an incision, bleeding, prolonged swelling, asymmetry, difficulty closing the eyes and revision. Weakness of the nerve that raises the brow is the most feared complication; it is uncommon and temporary weakness is far more frequent than permanent paralysis.2,1 In a national survey, patient satisfaction after endoscopic brow lift was above 98%.2
Travelling to Istanbul for a brow lift
Many patients travel from other cities or countries. A clear plan makes the trip calmer and safer:
- Online consultation first: most international patients start with an online consultation. Send your concern, your medical history, your medicines and a few clear photos through the channel the practice arranges, before you book flights.
- Arrive at least one day before surgery: the anaesthesia assessment and the final examination take place before the day of the operation.
- Hospital stay: usually one night; a second night is optional.
- Time in Istanbul: plan about a week, until the stitches or staples are removed.2
- Follow-up: reviews are planned at 1 month, 3 months, 6 months and 1 year. They can be done online if you live abroad; you will know whom to contact for urgent questions after you return home.
Dr. Atmış and the upper face
Op. Dr. Esin Özlem Atmış is an ENT and facial surgeon in Istanbul. She completed her specialist training in otorhinolaryngology at Ankara University Faculty of Medicine in 2014 and is a member of the Turkish Facial Plastic Surgery Association. She is one of the congress presidents of Face Bosphorus 3 (Istanbul, April 2026), a meeting on facial anatomy and medical practice. At Face Bosphorus 2025 she gave an opening talk and chaired sessions on the upper face and periorbital region, biostimulators and whole-face assessment; she was a listed speaker at Face Minima 2025, and at the 4th Congress of European ORL-HNS in Barcelona (2017) she chaired sessions that included facial anatomy. Details are on her scientific activities page.
The upper face and periorbital region were the subject of the sessions she chaired at Face Bosphorus 2025. Brow position, eyelid skin and eye shape are therefore judged together, and the brow is lifted to a height that suits your face rather than to a fixed standard.
Her approach starts with understanding the concern before discussing an operation: what has changed, how it affects you, and which structures are actually responsible. The aim is a proportionate plan that keeps your expression and character, which sometimes means a smaller procedure, a different order of treatment, or no surgery. Besides Turkish, she speaks English and Italian.
Frequently asked questions
Will I look surprised?
Not if the shape is planned carefully. Most faces need the lift mainly at the outer half of the brow, while the inner brow is kept natural.
How long does a brow lift last?
The effect can last many years, sometimes a lifetime, although some patients eventually choose to repeat it.1
Will I lose hair along the incision?
A small area of hair loss is possible. Incisions placed parallel to the hair follicles help to avoid it.1,2
Is numbness normal?
Yes. Temporary numbness or itching of the forehead and scalp is the most common effect and usually improves.1,2
Can Botox do the same thing?
Botulinum toxin can give a small, temporary change in brow shape. It does not reposition a heavy brow.
Can a brow lift be combined with eyelid surgery?
Yes, and it often is, because eyelid surgery alone cannot lift the brow.1
Clinical references
- Cleveland Clinic. Forehead (brow) lift.
- Raggio BS, Winters R. Endoscopic Brow Lift. StatPearls, NCBI Bookshelf (updated 2025).
- Hohman MH. Pretrichial Brow Lift. StatPearls (updated 2024).
- Perioperative management of antithrombotic medications: guidelines from the American College of Chest Physicians (summary in Am Fam Physician, 2023).
- Mayo Clinic. Blepharoplasty.
- American Society of Anesthesiologists. Herbal and dietary supplements and anesthesia (patient leaflet).
- Mayo Clinic. Face-lift.
- American Society of Anesthesiologists. Multi-society guidance on GLP-1 receptor agonists before elective surgery (2024).
- American Society of Plastic Surgeons. How nicotine sabotages plastic surgery.
This page is general information, not a personal diagnosis or treatment recommendation. Medicines must never be stopped without the advice of the doctor who prescribed them. Seek urgent medical care for heavy bleeding, rapidly increasing swelling, breathing difficulty, chest pain or sudden vision changes after surgery.
Start with a careful, honest consultation.
A consultation is not a commitment to surgery. It is where your concern, your anatomy and your health are looked at together.